Mental Health

ADHD

Key Points

While there is controversy surrounding ADHD diagnoses, male adolescents have an ADHD diagnosis rate that is three times that of adolescent females.About two-thirds of those with a current diagnosis receive prescriptions for stimulants like Ritalin or Adderall, which can drastically improve the lives of those with ADHD but can also lead to addiction, anxiety and occasionally psychosis. It is speculated that such widespread prescribing has led to unnecessary dependence and the use of them by friends and others for which they were not prescribed.

In recent years non-medication forms of ADHD treatment have emerged that show some evidence of success. Psychologists are developing behavioral interventions that parents, teachers and others can use to help kids focus and control their impulses. Others are conducting research that demonstrates that more exercise and longer sleep can help.1

The primary care clinician should initiate an evaluation for ADHD for any child 4 through 18 years of age who presents with academic or behavioral problems and symptoms of inattention, hyperactivity, or impulsivity (American Academy of Pediatrics).

Overview

While there is controversy surrounding ADHD diagnoses, male adolescents have an ADHD diagnosis rate that is three times that of adolescent females. According to recent data from the Centers for Disease Control and Prevention, nearly 20% of high school age boys have received the diagnosis. Fifteen percent of school-age boys have received an ADHD diagnosis, the data showed; the rate for girls was 7 percent. Diagnoses among those of high-school age — 14 to 17 — were particularly high, 10 percent for girls and 19 percent for boys. About one in 10 high-school boys currently take ADHD medication, the data showed.2

The figures showed that an estimated 6.4 million children ages 4 through 17 had received an ADHD diagnosis at some point in their lives, a 16 percent increase since 2007 and a 41 percent rise in the past decade. About two-thirds of those with a current diagnosis receive prescriptions for stimulants like Ritalin or Adderall, which can drastically improve the lives of those with ADHD but can also lead to addiction, anxiety and occasionally psychosis.3

In recent years non-medication forms of ADHD treatment have emerged that show some evidence of success. Psychologists are developing behavioral interventions that parents, teachers and others can use to help kids focus and control their impulses. Others are conducting research that demonstrates that more exercise and longer sleep can help.4

ADHD is characterized by a pattern of behavior, present in multiple settings (e.g., school and home), that can result in performance issues in social, educational, or work settings. Symptoms are divided into two categories of inattention and hyperactivity and impulsivity that include behaviors like failure to pay close attention to details, difficulty organizing tasks and activities, excessive talking, fidgeting, or an inability to remain seated in appropriate situations. AHDH symptoms may explained by another mental disorder, such as a depressive or bipolar disorder, anxiety disorder, dissociative disorder, personality disorder, or substance intoxication or withdrawal.5

Sales of stimulants to treat ADHD have more than doubled to $9 billion in 2012 from $4 billion in 2007, according to the health care information company IMS Health.

It is speculated that such widespread prescribing of the drugs has led to unnecessary dependence and the use of them by friends and others for which they were not prescribed.